These injuries resemble those seen in multiple widely publicized cases of athletes who experience repeated concussions, which has led to changes in rules, equipment, and game culture. But the situation is more complex and difficult for military personnel, who may not have the option of retreating to safety after an injury and may not be eager to even complain of apparently invisible injuries.

But the Department of Veterans Affairs (VA) has begun to take notice, and has proposed new regulations that will ease the ability of veterans with a history of TBI to receive treatment and compensation. The proposed regulations were published this week in the Federal Register, and acknowledge a possible link between service-related TBI and Parkinson's disease, seizures, and some types of dementia, depression, and hormone deficiency diseases.

The proposal, entitled "Secondary Service Connection for Diagnosable Illnesses Associated with Traumatic Brain Injury," states: "VA recognizes that not all those who suffer a TBI during military service seek immediate medical assistance and receive a medical assessment of the severity of the TBI."

A New York Times article about the proposed regulations noted that the last time veterans saw their benefits expanded was 2 years ago, for illnesses related to exposure to Agent Orange in Vietnam. At that time, the article noted, there was "a tidal wave of new claims," significantly adding to the department's backlog -- which already is almost 900,000. But the VA is not planning on adding staff, according to the Times article, despite the fact that an estimated 250,000 veterans of the Iraq and Afghanistan wars may have had TBIs.

Nancy Walsh has written for various medical publications in the United States and England, including Patient Care, The Practitioner, and the Journal of Respiratory Diseases. She also has contributed numerous essays to several books on history and culture, most recently to The Book of Firsts (Anchor Books, 2010).

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